DBB - Marom - Medical Board Document

download DBB - Marom - Medical Board Document

of 21

  • date post

    08-Apr-2015
  • Category

    Documents

  • view

    127
  • download

    1

Embed Size (px)

Transcript of DBB - Marom - Medical Board Document

MISSISSIPPI STATE BOARD OF MEDICAL LICENSURE 1867 CRANE RIDGE DRIVE, SUITE 200-B JACKSON, MISSISSIPPI 39216 (601) 987-3079 Professional Verification Report for License: 18789 Generated on: 09/12/2010 at 04:03:19 PM

Name: Degree: Date of Birth: Primary Practice Location: License Number: Issue Date: Expiration Date: Date of Expiration Prior to Reinstate Date: Reinstated Date: MD/DO/DPM/PA School: Year of Graduation: Physician Specialty: Public Record: License Type:

ZVI MAROM MD 05/15/1942 WINSTON MEDICAL CENTER 562 EAST MAIN LOUISVILLE, MS 39339 18789 01/10/2005 06/30/2011 05/20/2010 07/22/2010 Israel (Primary Source Verified) Unknown GENERAL PRACTICE (Not Primary Source Verified) YES MD

[Page 1 of 21]

[Page 2 of 21]

[Page 3 of 21]

[Page 4 of 21]

[Page 5 of 21]

[Page 6 of 21]

[Page 7 of 21]

[Page 8 of 21]

[Page 9 of 21]

[Page 10 of 21]

[Page 11 of 21]

[Page 12 of 21]

[Page 13 of 21]

[Page 14 of 21]

[Page 15 of 21]

[Page 16 of 21]

[Page 17 of 21]

[Page 18 of 21]

[Page 19 of 21]

[Page 20 of 21]

[Page 21 of 21]